Nursing Elites

1. Following a total hip arthroplasty, what intervention should the healthcare provider implement for the client?

• A. Place a pillow between the client's legs.
• B. Elevate the head of the bed to 45 degrees.
• C. Position the client on the operative side.
• D. Keep the client’s legs adducted.

Correct answer: A

Rationale: Placing a pillow between the client's legs is crucial post hip arthroplasty surgery to prevent hip dislocation. This intervention helps maintain proper alignment and prevents legs from crossing midline, reducing the risk of hip prosthesis dislocation. Elevating the head of the bed to 45 degrees, positioning the client on the operative side, or keeping the client's legs adducted are not recommended postoperative interventions for a total hip arthroplasty, as they can increase the risk of complications and compromise the surgical site.

2. A client has a new prescription for a metered-dose inhaler (MDI). Which of the following statements indicates an understanding of the teaching?

• A. I will shake the inhaler before use.
• B. I will breathe out forcefully after inhaling the medication.
• C. I will take the medication with food.
• D. I will use a spacer with the inhaler.

Correct answer: A

Rationale: The correct answer is A: 'I will shake the inhaler before use.' Shaking the inhaler before use is crucial to ensure proper mixing of the medication inside the inhaler. This action helps to disperse the medication evenly, allowing for consistent dosing during inhalation. Choices B, C, and D are incorrect. Breathing out forcefully after inhaling the medication, taking the medication with food, and using a spacer with the inhaler are not related to the correct use of a metered-dose inhaler. These actions may not lead to optimal medication delivery and do not demonstrate an understanding of the proper technique for using an MDI.

3. A client with a new diagnosis of chronic kidney disease is being taught about dietary management. Which of the following statements should be included in the teaching?

• A. Increase your intake of protein-rich foods.
• B. Decrease your intake of phosphorus-rich foods.
• C. Avoid foods that contain lactose.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: In chronic kidney disease, decreasing the intake of phosphorus-rich foods is essential as impaired kidney function can lead to difficulty in excreting phosphorus, causing an imbalance. This can result in bone and heart complications. Therefore, educating the client to reduce phosphorus intake is crucial for managing the disease and preventing further complications. Option A is incorrect because excessive protein intake can burden the kidneys. Option C is not directly related to the management of chronic kidney disease. Option D is also incorrect as potassium intake may need to be limited in certain stages of kidney disease.

4. A healthcare provider is preparing to administer an intramuscular injection to an adult client. Which of the following injection sites should the healthcare provider select?

• A. Deltoid muscle
• B. Dorsogluteal muscle
• C. Vastus lateralis muscle
• D. Rectus femoris muscle

Correct answer: A

Rationale: The deltoid muscle is a common site for intramuscular injections in adults due to its accessibility and muscle mass. It is located in the upper arm and provides a sufficient area for injection. The deltoid muscle is preferred for administering vaccines and other medications that require IM administration. Choice B, the dorsogluteal muscle, is not recommended for intramuscular injections due to the proximity of major nerves and blood vessels in that area, which can lead to nerve damage or injury. Choice C, the vastus lateralis muscle, is more commonly used for infants and young children, while choice D, the rectus femoris muscle, is not typically used for intramuscular injections in adults.

5. When teaching a client with a new diagnosis of hypertension about medication adherence, which statement should the nurse include?

• A. You can stop taking your medication once your blood pressure is normal.
• B. You should take your medication at the same time every day.
• C. You can double your dose if you miss a dose.
• D. You should take your medication with a high-fat meal.

Correct answer: B

Rationale: The correct answer is B: 'You should take your medication at the same time every day.' Taking medication consistently at the same time daily is crucial for maintaining steady blood levels and effectively managing hypertension. It helps ensure that the medication works optimally and provides the best control of blood pressure throughout the day. Choice A is incorrect because stopping medication once blood pressure is normal can lead to a relapse or worsening of hypertension. Choice C is incorrect as doubling the dose without healthcare provider guidance can be dangerous. Choice D is incorrect as taking medication with a high-fat meal can affect its absorption and efficacy.

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